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A patient presents with chest pain that occurs during heavy lifting or physical exertion and is relieved by rest. An electrocardiogram (ECG) may show transient ST-segment depression. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Acute myocardial infarction
- D. Prinzmetal's angina
Correct Answer: A
Rationale: The given patient's symptoms of chest pain that occurs during heavy lifting or physical exertion and is relieved by rest are consistent with stable angina. Stable angina is characterized by predictable chest pain that occurs with exertion and is typically relieved by rest or nitroglycerin. The transient ST-segment depression on ECG is also a common finding in patients with stable angina, which reflects myocardial ischemia during episodes of chest pain triggered by exertion. In contrast, unstable angina is characterized by chest pain at rest or with minimal exertion that is of increasing frequency, severity, or duration. Acute myocardial infarction is associated with persistent ST-segment elevation or new Q-waves on ECG, and Prinzmetal's angina is characterized by chest pain at rest due to coronary artery spasm rather than exertion.
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A patient with a history of cirrhosis is at risk for developing hepatic encephalopathy. Which nursing intervention is most effective in preventing and managing hepatic encephalopathy?
- A. Administering lactulose as prescribed
- B. Restricting dietary protein intake
- C. Monitoring serum ammonia levels
- D. Encouraging increased fluid intake
Correct Answer: A
Rationale: Lactulose is the most effective nursing intervention in preventing and managing hepatic encephalopathy in patients with cirrhosis. Lactulose works by promoting the elimination of ammonia in the colon through its laxative effect, thereby reducing ammonia levels in the blood. High ammonia levels are associated with the development of hepatic encephalopathy. By administering lactulose as prescribed, nurses can help reduce the risk of encephalopathy and manage symptoms effectively. Monitoring serum ammonia levels is important in assessing the effectiveness of lactulose therapy, but administering lactulose is the primary nursing intervention in this situation. Dietary protein restriction is also commonly recommended; however, lactulose administration is the most vital intervention in this scenario. Additionally, encouraging increased fluid intake is important for overall liver health but is not as specific to preventing and managing hepatic encephalopathy as administering lactulose.
In conducting a study on sleep, Nurse Trining was asked which of the types of research will be used should it involve collecting numerical data which is most often under considerable control. Her answer should be _________.
- A. Ichnographic
- B. Qualitative
- C. Phenomenological
- D. Quantitative
Correct Answer: D
Rationale: Quantitative research is the type of research that involves collecting numerical data, which can be easily quantified and analyzed statistically. It is characterized by its structured methodology, objectivity, and the ability to control variables to a considerable extent. In the context of a study on sleep, where data related to sleep patterns, duration, quality, etc., need to be measured and analyzed in a systematic manner, quantitative research would be the most appropriate choice. This type of research allows for a more precise understanding of the relationships and patterns within the data, providing valuable insights into the sleep-related factors being studied.
A postpartum client expresses concerns about breastfeeding and worries about inadequate milk supply. What nursing intervention should be prioritized to address the client's concerns?
- A. Assessing the infant's latch and feeding effectiveness
- B. Recommending supplemental formula feedings to ensure adequate nutrition
- C. Educating the client about techniques to increase milk production
- D. Referring the client to a lactation consultant for assistance
Correct Answer: A
Rationale: Assessing the infant's latch and feeding effectiveness should be prioritized as the initial nursing intervention to address the client's concerns about inadequate milk supply. Poor latch can lead to ineffective milk removal, which may result in decreased milk production. By ensuring the infant is latching correctly and effectively transferring milk, the client's milk supply can be optimized. Education about techniques to increase milk production can be provided following the assessment of feeding effectiveness. Referring to a lactation consultant may be necessary for further evaluation and support if issues persist despite correcting the latch. Supplemental formula feedings should be recommended as a last resort after all other interventions have been attempted and if there are concerns about inadequate nutrition for the infant.
In what way wil1 the nurse handles the situation?
- A. Tell her to trust on God's love and mercy.
- B. Te1l her that death is a reality.
- C. Encourage her to keep calm because the health care team I doing their best to help Ramon recover
- D. Encourage the mother to express more about her thoughts and feelings
Correct Answer: C
Rationale: In this situation, the most appropriate way for the nurse to handle it would be to encourage the mother to keep calm because the health care team is doing their best to help Ramon recover. This response acknowledges the mother's concerns and reassures her that everything possible is being done for her son's well-being. It also helps to foster trust and rapport between the nurse, mother, and the healthcare team, which is important for effective communication and support during a challenging time. Promoting a sense of calm and trust in the healthcare professionals can help alleviate the mother's anxiety and stress, allowing her to focus on being a supportive presence for her son.
A patient with chronic kidney disease presents with progressively worsening anemia and elevated serum phosphate levels. Which medication is commonly prescribed to reduce serum phosphate levels in patients with chronic kidney disease?
- A. Epoetin alfa
- B. Cinacalcet
- C. Sevelamer
- D. Allopurinol
Correct Answer: C
Rationale: Sevelamer is a medication commonly prescribed to reduce serum phosphate levels in patients with chronic kidney disease. Sevelamer is a phosphate binder that works by binding to dietary phosphate in the gut, preventing its absorption into the bloodstream. By reducing serum phosphate levels, sevelamer helps manage complications associated with hyperphosphatemia in chronic kidney disease patients, such as mineral and bone disorders. Other medications like epoetin alfa are used to treat anemia commonly seen in chronic kidney disease patients, while cinacalcet is used to manage secondary hyperparathyroidism. Allopurinol, on the other hand, is used to treat gout by reducing uric acid levels and is not indicated for reducing serum phosphate levels in chronic kidney disease patients.